Getting It Right One Ward at a Time

In Summer 2015,
NHS Greater
Glasgow and Clyde (
NHSGGC)
health board merged three
ED departments and
the inpatient services from five former sites into a new flagship
hospital for Glasgow. The Queen Elizabeth University Hospital is
the largest acute hospital site in the
UK, with 1500 beds,
arranged across 40+ wards.

Bringing together staff from so many different hospitals,
each with different cultures and different ways of working, proved
to be a major challenge for
NHS Greater
Glasgow and Clyde. It has taken time for staff to adjust to new
colleagues, a new environment and new ways of working.

The hospital adapted the Daily Dynamic Discharge model
[1] from the Scottish Government's programme, 6 Essential
Actions to Improve Unscheduled Care, rebranding it as Exemplar
Ward. The aim was to improve patient flow and provide structure to
the day-to-day ward routine. Rather than trying to introduce
service improvements on all wards simultaneously, Queen Elizabeth
University Hospital uses Exemplar Wards. Getting things right one
ward at a time ensures the approach is cascaded to all of its wards
in a measured and sustained way. This is their
story…

The move to a brand new state-of-the-art hospital was an
exciting opportunity for staff in
NHS Greater
Glasgow and Clyde and a positive development for patients. But it
was also hugely challenging, as Service Improvement Manager, Peter
McInnes explained:

"It was necessary to allocate staff to wards to ensure an even
mix of skills coming together from the original hospitals. At first
it was difficult for them to establish a team ethos and develop
leadership roles in a completely new setting. They were still being
measured against all of the usual performance measures so it was
important to establish the authority of Senior Charge Nurses as
quickly as possible and to empower them to take charge of their
wards and create a well-functioning and efficient environment.
Pre-noon discharge was a key aim."